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Research and Clinical Trials
More on Alzheimer's Disease
Neurology and Neuroscience
About Alzheimer's Disease
Alzheimer's disease is a progressive, neurodegenerative disease that causes impaired memory and behavior, personality changes, and other symptoms. Alzheimer's affects one in 10 people over age 65 and nearly half of people over age 85. It is the most common cause of dementia, a disorder in which a person's mental functions deteriorate.
About NewYork-Presbyterian's Approach to Alzheimer's Disease
At NewYork-Presbyterian Hospital patients with Alzheimer's disease are cared for by a multidisciplinary team of healthcare professionals. This team provides comprehensive diagnostic services, neuropsychological assessments, sophisticated neuroimaging techniques, patient and caregiver education, state-of-the-art treatment, and assistance planning and managing patient care.
Doctors who treat Alzheimer's patients at NewYork-Presbyterian/Columbia are members of the Gertrude H. Sergievsky Center and/or the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, and of Columbia's Alzheimer's Disease Research Center, one of 28 specialized Centers around the country sponsored by the National Institute on Aging. Patients are seen at the state-of-the-art Lucy G. Moses Center for Memory and Behavioral Disorders and the Memory Disorders Center at the New York State Psychiatric Institute. At NewYork-Presbyterian/Weill Cornell Alzheimer's patients are cared for by members of the Memory Disorders Program.
Prevention of Alzheimer's Disease
The cause of Alzheimer's disease is unknown, so there are no proven prevention guidelines to follow at this time. Researchers are working to define risk factors for the disease and studying substances that have the potential to reduce the risk. One recent new study, for example, suggests that nonsteroidal anti-inflammatory medications may lower the risk of Alzheimer's disease. The finding appears to confirm that inflammation plays a role in the disease. Further study is needed to identify whether any of these medications can safely prevent the onset of Alzheimer's.
Diagnosis of Alzheimer's Disease
Alzheimer's patients have characteristic changes in the brain, but there is no single, comprehensive test for diagnosing the disease. Doctors diagnose Alzheimer's by ruling out other conditions through a process of elimination. The only way to confirm a diagnosis of Alzheimer's disease is through autopsy.
When Alzheimer's disease is detected in its early stages, treatment can begin earlier and its effectiveness is increased as most medications currently available or in development can only slow the patient's descent into forgetfulness. Doctors at NewYork-Presbyterian are using a new brain imaging technique called quantitative diffusion tensor imagery to distinguish Alzheimer's from treatable disorders with similar symptoms such as normal pressure hydrocephaly. Doctors here also conduct genetic testing for the disease in people with a family history of Alzheimer's.
Medical Treatment for Alzheimer's Disease
There is no cure for Alzheimer's disease today, and no way to reverse the deterioration it causes. Two kinds of medications are now available to treat the cognitive symptoms of Alzheimer's disease. In the early stage of the disease doctors may prescribe drugs called cholinesterase inhibitors (Aricept, Cognex, Exelon, and Razadyne), which can delay the worsening of symptoms for several months in about half of the people. In patients with moderate to severe forms of the disease doctors may prescribe Namenda, a drug that regulates levels of glutamate in the brain, and which may delay the worsening of symptoms in some people. Other medications can help manage symptoms such as depression, behavioral disturbance, and sleeplessness.
New research findings give reason for hope, though, and several drugs are being studied in clinical trials to determine if they can slow the progress of the disease or improve memory for a period of time.
Rehabilitation for Alzheimer's Disease Patients
Rehabilitation involving structured activities can be an important aspect of treatment for Alzheimer's patients. Regular physical exercise and social activities can provide Alzheimer's patients with structure, meaning, and a sense of accomplishment, and help manage some behavioral symptoms of the disease.
Research for Alzheimer's Disease
Investigators at NewYork-Presbyterian's Columbia University Medical Center campus participate in extensive research programs sponsored through the Sergievsky Center, the Taub Institute, and the Alzheimer's Disease Research Center. Current research is directed toward:
- New neuroimaging techniques to diagnose and monitor disease by assessing the accumulation of amyloid, the protein found in Alzheimer's plaques, with Positron Emission Tomography (PET)
- Special genetic studies to find new genes and assess the contribution of genetic factors to neurologic disease
- Studies designed to understand risk factors affecting the course of disease
- Studies of new drugs to improve disease symptoms
Researchers in the Memory Disorders Program at NewYork-Presbyterian's Weill Cornell Medical Center campus focus on turning basic research into effective clinical treatments. Alzheimer's disease research at Weill Cornell is conducted by the Appel Center for Alzheimer's Translational Clinical Research; clinical trials are performed at the NIH-sponsored Clinical Translational Science Center; and clinical and research brain imaging studies are carried out at the Citigroup Biomedical Imaging Center. Current projects are investigating:
- The genetic underpinnings of Alzheimer's disease
- Biological markers that could be used as treatment targets
- Characterizing proteins found in the brains of patients with dementia
- The development of immunization-based treatments such as intravenous immune globulin (IVIG)
- The effectiveness of agents that target amyloid, the protein found in Alzheimer's plaques
- New neuroimaging techniques to diagnose and monitor disease by assessing the accumulation of amyloid with Positron Emission Tomography (PET)